Gephart SM, Spitzer AR, Effken JA, Dodd E, Halpern M, McGrath JM. Discrimination of GutCheckNEC: a clinical risk index for necrotizing enterocolitis. J Perinatol. 2014. The Pediatrix group have developed a scoring system for predicting the risk of NEC; points are given for a number of different items, and then added. The process of developing it is well described, it took me a while to find where is the cut off for the score, but in figure 3 it is noted that the threshold is 32. If you have a score more than that you at increased risk, less than that you are at decreased risk. Interestingly, the positive risk factors, which reduce the risk, include probiotics! Also interestingly the background incidence of NEC in the individual NICU is by far the most important risk factor. Human milk feeding on both days 7 and 14 was another protective factor. Many of the risk factors are not modifiable, but those 2 certainly are.